You're Too Young to Be Here

Today, on Day 8 of my radiation treatment, I spoke to my radiation therapist about a pain in my chest. She examined me and concluded that it was too early for potential side effects, and that everything seemed normal. She added however that she doesn't typically have patients that are as physically active as I am, and that it is possible that my level of activity might have something to do with it. I suspected that she was accustomed to treating an older population and that this might have had something to do with why her patients were less physically active, and I raised this point with her. She responded that most of her patients with Hodgkin's fall into my age group, yet typically they are too tired to exercise.

It is possible that I am simply lucky to have such a high level of energy during my cancer treatment. It is also possible that the dreaded fatigue that is associated with radiation just hasn't yet hit me, although I do know that during my four months of chemotherapy, I worked out at least three times a week, including the day after chemo. My exercise classes helped me feel normal and the pumping music and energy in the class contributed to a sense of well-being and also made me forget how much I wanted to vomit.

Yet to be completely honest, I don't think that I am anything special - there are others in my young adult support group who are also going to the gym. Rather, I really do think that physicians, including my own, just aren't used to treating younger patients. Why? Because as a general rule, it is older people who get cancer. While Hodgkin's patients do bring down the average age of the adult cancer population, there aren't many of us with the disease, and I will bet that my radiation therapist typically sees patients who can at least remember where they were on the day of John F. Kennedy's assassination. At the very least, they were born by then.

A quick look around the radiation waiting room at my hospital room reveals that I am the youngest person there (by several decades), and this was also the case in the chemotherapy unit. On occasion, I will bump into a young, bald woman in the halls who I know from my support group, but other than that, I mainly see people who look like they could play bridge with my grandmother. In fact, during one of my chemotherapy treatment sessions, as I energetically walked down the hall with IV bags in tow, an older man looked at me and simply said, in an almost accusatory tone, that I was too young to be there. I don't think that my hospital is different than any other hospital - I simply think that there are not, relatively speaking, a lot of young adults with cancer.

During the course of my cancer treatment, it has become clear to me that oncologists, radiation therapists and their staff are used to treating older patients, and this is reflected in their expectations towards cancer patients. These professionals are simply not accustomed to dealing with younger patients, because twenty and thirty-year-olds are typically off starting their careers and families rather than coming in to see them.

The concern here is that since their practices are geared towards treating older people, there may be any number of social, biological, and medical issues that physicians are missing when they treat young adults. Cancer treatment is divided into childhood cancers on the one hand, and adult cancers on the other, and since adult cancers typically strike people well past their twenties and thirties, there is a gap when it comes to treating young adults. According to the Vanderblit-Ingram Cancer Center, in contrast to younger and older cancer patients, survival rates for young adults have not increased since 1975. There are a number of possible reasons for this, including later diagnosis (since no one expects a thirty-year-old to have cancer) and lack of enrollment in clinical trials. The media has gradually began to notice this, especially since cancer rates among young adults are increasing, as noted in the New York Times. It is unclear why more young adults are getting cancer - although I have a sneaking suspicion that the influx of chemicals in our food, in the products we use and in the air we breath may have something to do with it - but I digress. What I do think is clear is that cancer will affect a thirty-year-old body in a different way than it will affect a seventy-year-old body. Beyond this, there are unique social issues that a young adult with cancer will face. The sad truth is that cancer treatment in young adults has fallen through the cracks and young adults are paying with their health.